CPR Blog

CPR Is A System Effort

I have visited hundreds of facilities and every hospital has a "Code Team", "Code Blue", or "Dr. Heart" (aka we don't want to tell visitors someone is dying in our hospital because no one dies here) team. It is not important what the team is called, just so long as the team functions well. Enter the American Heart Association's Taxonomy of Systems of Care (SPSO).

Crash Carts play a major role in codes but many staff feel unsure of what items are in a crash cart.

At the CPR Training Company, we have been thinking about the Taxonomy of Systems of Care (SPSO), Part 4 of the 2015 CPR & ECC Guidelines, and how healthcare resuscitation "systems" relate to reviving code teams. It is tempting to spend time writing about how, yet again, the American Heart Association (AHA) put forth an algorithm fix to a problem that is not easily fixed by an algorithm but this writer's main point is the SPSO graphic can be a valuable educational tool for visual learners in your facility's leadership team.

The American Heart Association notes their Taxonomy of Systems of Care flowchart "[looks] at the Structure Process System Outcome or SPSO" and [puts SPSO] in a framework of continuous quality improvement". We have presented the AHA's SPSO content to Resuscitation Committees and leadership with mixed reviews. Perhaps that is because those in attendance saw our team in the educational role when in reality education is just a small fraction of the AHA's SPSO model.

The AHA's Systems of Care model is a good model and our experience indicates implementing the model requires a lot of hard work. First start by cobbling together an intraprofessional team made up of key stakeholders from areas such as your supply chain, educational team, clinical simulation program, policy wonks, patient safety, and most importantly quality management. We cannot stress enough that in the end of the day the resuscitation program must be owned by the facility's quality management team with direct accountability to the facility's top leader. Why do you ask?

AED in Elevator Is An Example of a Systems Fix

The only major developmental/planning problem we experience with the SPSO model is the model often rolls out though the education channel when in reality the model needs to be roll out the Quality Management channel. To be sure education and clinical simulation will play a part in resuscitation process improvement but education only plays a smaller role. Again the impact of education implementing and running the Taxonomy of Systems of Care (SPSO), while important, will be very short lived (and perhaps fall apart) if the Quality Management apparatus is not tasked with being the primary leader.

So that is our take on the American Heart's Taxonomy of Systems of Care (SPSO) model, what is yours? Share your answer in the comments section.